| NPI | 1285051847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: HI DT2385) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: CA 61868) |
| Enumeration Date | 2014-03-20 |
| Last Update Date | 2018-08-16 |